The Prognostic Role of HPV or p16INK4a Status in Penile Squamous Cell Carcinoma: A Meta-Analysis.

IF 14.8 2区医学 Q1 ONCOLOGY Journal of the National Comprehensive Cancer Network Pub Date : 2025-01-03 DOI:10.6004/jnccn.2024.7078

Arfa Mustasam, Kevin Parza, Filip Ionescu, Keerthi Gullapalli, Mahati Paravathaneni, Youngchul Kim, Reagan E Sandstrom, Majd Al Assaad, G Daniel Grass, Peter Johnstone, Steven Eschrich, Houssein Safa, Juskaran Chadha, Gabriel Roman Souza, Jerel David, Adele Semaan, Niki M Zacharias, Curtis Pettaway, Anna R Giuliano, Philippe E Spiess, Jad Chahoud

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引用次数: 0

Abstract

Background: HPV infection is implicated in approximately half of global penile squamous cell carcinoma (PSCC) cases. Previous studies on HPV DNA and p16INK4a status in PSCC have yielded inconclusive prognostic findings. This meta-analysis aims to elucidate the prognostic role of HPV in PSCC by pooling data on disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS).

Methods: We systematically searched Medline and Embase up to January 2023 for relevant human studies. Data from eligible publications reporting HPV DNA or p16INK4a status, along with and DFS, DSS, or OS outcomes, were extracted. A random-effects meta-analysis model was used to synthesize data, with study weights based on size and significance. The study protocol was registered with PROSPERO (CRD42019131355).

Results: Out of 544 studies screened, 34 publications were included, comprising a pooled sample size of 3,944 patients. p16INK4a-positive status was associated with improved OS (hazard ratio [HR], 0.54; 95% CI, 0.39-0.75; I2=31%), DFS (HR, 0.52; 95% CI, 0.29-0.94; I2=20%), and DSS (HR, 0.34; 95% CI, 0.23-0.50; I2=18%). HPV DNA positivity was significantly associated with improved DFS (HR, 0.63; 95% CI, 0.46-0.87; I2=13%) and DSS (HR, 0.46; 95% CI, 0.29-0.75; I2=47%) but not OS (HR, 0.92; 95% CI, 0.74-1.11; I2=0%).

Conclusions: This meta-analysis, comprising the largest number of patients with PSCC to date, shows a notable correlation between p16INK4a immunohistochemistry positivity and survival outcomes. These findings support the understanding that penile cancer cases not associated with HPV tend to behave more aggressively. We support p16INK4a immunohistochemistry testing as part of the initial diagnostic evaluation of patients with PSCC.

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HPV或p16INK4a在阴茎鳞状细胞癌中的预后作用：一项荟萃分析

背景：HPV感染与全球大约一半的阴茎鳞状细胞癌（PSCC）病例有关。先前对PSCC中HPV DNA和p16INK4a状态的研究没有得出确定的预后结果。本荟萃分析旨在通过汇总无病生存期（DFS）、疾病特异性生存期（DSS）和总生存期（OS）的数据来阐明HPV在PSCC中的预后作用。方法：我们系统地检索Medline和Embase到2023年1月的相关人体研究。从符合条件的报告HPV DNA或p16INK4a状态的出版物中提取数据，以及DFS、DSS或OS结果。采用随机效应荟萃分析模型对数据进行综合，根据研究规模和显著性确定研究权重。研究方案已在PROSPERO注册（CRD42019131355）。结果：在筛选的544项研究中，包括34篇出版物，包括3,944例患者的汇总样本量。p16ink4a阳性状态与OS改善相关(风险比[HR]， 0.54；95% ci, 0.39-0.75；I2=31%), DFS (hr, 0.52；95% ci, 0.29-0.94；I2=20%), DSS (HR, 0.34；95% ci, 0.23-0.50；I2 = 18%)。HPV DNA阳性与DFS改善显著相关(HR, 0.63；95% ci, 0.46-0.87；I2=13%)和DSS (HR, 0.46；95% ci, 0.29-0.75；I2=47%)，但OS无差异(HR, 0.92；95% ci, 0.74-1.11；I2 = 0%)。结论：这项荟萃分析包括迄今为止最多的PSCC患者，显示p16INK4a免疫组化阳性与生存结果之间存在显著相关性。这些发现支持了一种理解，即与HPV无关的阴茎癌病例往往表现得更有攻击性。我们支持p16INK4a免疫组织化学检测作为PSCC患者初始诊断评估的一部分。

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来源期刊

Journal of the National Comprehensive Cancer Network ONCOLOGY-

CiteScore

20.20

自引率

0.00%

发文量

388

审稿时长

4-8 weeks

期刊介绍： JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.